Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Aug 8, 2017; 9(22): 953-958
Published online Aug 8, 2017. doi: 10.4254/wjh.v9.i22.953
Addictive behaviors in liver transplant recipients: The real problem?
Hélène Donnadieu-Rigole, Pascal Perney, José Ursic-Bedoya, Stéphanie Faure, Georges-Philippe Pageaux
Hélène Donnadieu-Rigole, Department of Addictology, Saint Eloi University Hospital, University of Montpellier, 34295 Montpellier, France
Pascal Perney, Department of Addictology, Caremeau Hospital, 30000 Nîmes, France
José Ursic-Bedoya, Stéphanie Faure, Georges-Philippe Pageaux, Liver Transplantation Unit, Saint Eloi University Hospital, University of Montpellier, 34295 Montpellier, France
Author contributions: Donnadieu-Rigole H reviewed the literature and wrote the manuscript; Perney P, Ursic-Bedoya J, Faure S and Pageaux GP revised the manuscript; all authors contributed equally to this paper.
Conflict-of-interest statement: The authors declare there is no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Hélène Donnadieu-Rigole, MD, PhD, Department of Addictology, Saint Eloi University Hospital, University of Montpellier, Rue Augustin Fliche, 34295 Montpellier, France.
Telephone: +33-4-67337020 Fax: +33-4-67337869
Received: January 26, 2017
Peer-review started: February 3, 2017
First decision: March 17, 2017
Revised: April 12, 2017
Accepted: May 22, 2017
Article in press: May 24, 2017
Published online: August 8, 2017

Liver transplantation (LT) is the gold standard treatment for end-stage liver disease. Whatever the primary indication of LT, substance abuse after surgery may decrease survival rates and quality of life. Prevalence of severe alcohol relapse is between 11 and 26%, and reduces life expectancy regardless of the primary indication of LT. Many patients on waiting lists for LT are smokers and this is a major risk factor for both malignant tumors and cardiovascular events post-surgery. The aim of this review is to describe psychoactive substance consumption after LT, and to assess the impact on liver transplant recipients. This review describes data about alcohol and illicit drug use by transplant recipients and suggests guidelines for behavior management after surgery. The presence of an addiction specialist in a LT team seems to be very important.

Keywords: Liver transplantation, Tobacco use, Illicit drugs, Behavior management, Severe alcohol relapse

Core tip: Liver transplantation is the best treatment for end-stage liver disease. However, some transplant recipients use or abuse alcohol, tobacco and illicit drugs during the post-transplant period. Given the scarcity of organs, this type of consumption, which can affect life expectancy and quality, must be addressed with kindness and without moralizing. Although specific behavior treatment does not exist in this indication, specialists in addiction should be part of the transplant team.